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Biomedical subjects

T B Hunter

Publications and source records attributed to T B Hunter.

At least 19 recordsLinked to original sources
PubMed1992

Interventional procedures in diseases of the breast: needle biopsy, pneumocystography, and galactography.

This article discusses the roles of mammography-guided needle biopsy of the breast, pneumocystography, and galactography in further defining breast lesions that have been detected with mammography. For each procedure, indications for its use, proper technique, complications, interpretation, and role in clinical practice are described. Use of these procedures is warranted for some patients to provide detail beyond that available with mammography and sonography.

Adult↗
PubMed1990

Altered gastric and duodenal motility in intestinal obstruction.

There are no strict clinical or radiographic criteria that consistently indicate imminent strangulation in cases of small bowel obstruction. An intestinal obstruction with vascular compromise produces a marked retention of food, fluid, or contrast material in the stomach and duodenum, while an obstruction without vascular problems may show no change or somewhat delayed gastric emptying with some duodenal hypotonia. The association of gastric atony and profound stomach dilatation with strangulating, usually closed-loop intestinal obstruction, has generally not been appreciated by radiologists. We illustrate this phenomenon in 4 patients and emphasize its usefulness in evaluating intestinal obstructions.

Adult↗
PubMed1990

Computer use and education in radiology residency programs.

Computers play an increasingly important role in radiology education and research. We surveyed all U.S. residency programs to assess computer availability, education, and use by residents. Out of 210 questionnaires sent, 132 were returned (63% response). Areas of inquiry included computer equipment and software as well as resident use of facilities. Opinions were also solicited concerning the importance of computer literacy and education. Sixty-nine percent of the respondents have computer facilities (61% within the department). Predominant uses include scientific papers, slides/audiovisual presentations and resume preparation. Popular software includes word processing, spreadsheets, databases and graphics. Of those training programs with computers, 85% provided computer education, and most (70%) felt computer training was very important. Forty-seven percent expected their residents to have at least passing acquaintance with computers. However, in 60% of programs with computers, the computers are used by less than half the residents. Of those programs without a computer, 61% provided no computer training, and only 44% felt computer education was very important. A sizable minority of radiology residency programs are still without computer facilities. Those programs that have computers tend to place a greater emphasis on computer education and literacy for radiology residents. However, even in programs that have computers, it seems they are often underutilized by residents.

Computer User Training↗
PubMed1990

Comparison of breast consistency at palpation with breast density at mammography.

Palpable breast consistency on physical examination was compared with the breast density on mammography for 909 consecutive patients. One of two experienced nurse practitioners palpated each patient's breasts and assigned a consistency value of 1 (little palpable breast consistency) to 4 (maximal palpable breast consistency). Seven mammographers rated the breast density on mammography as either fatty, mild, moderate, or marked parenchymal density for each breast. A low statistical correlation between the two parameters was shown. Thirty-seven percent of markedly dense breasts on mammography was rated only 1 or 2 on palpation. Thus, breast consistency judged by palpation cannot be directly correlated with the density shown on mammography and cannot be used to predict optimal radiographic technique.

Adult↗
PubMed1990

Detection of breast abnormalities on teleradiology transmitted mammograms.

The authors conducted an observer performance study to compare breast lesion detection of conventional mammography (CM) with teleradiology (TE) transmitted mammograms. One hundred four abnormal, single-projection mammographic images were transmitted by teleradiology. Abnormalities included 11 cases with skin thickening or retraction, 48 cases with microcalcifications, and 52 with parenchymal masses. The CM and TE images were reviewed by four mammographers who indicated the type and location of abnormalities and a level of confidence for their diagnostic decisions. For each of three detection tasks--skin and nipple abnormalities, microcalcifications, and masses--receiver operating characteristic curve analysis was performed for individual readers and all readers as a group. For detecting skin and nipple abnormalities, readers performed significantly better with CM than with TE (z = 2.05, P = less than 0.04). However, no significant differences were found among readers for detection of either microcalcifications or masses. Further improvements in hardware and imaging parameters may improve detection of soft tissue abnormalities. Further evaluation is necessary to determine whether teleradiology might be applicable to breast cancer screening.

Breast Neoplasms↗
PubMed1989

Computer-assisted analysis of mammographic clustered calcifications.

A total of 127 biopsy-proven clustered mammographic calcifications were diagnosed and evaluated using multiple parameters. The results were subjected to computer analysis. The number of calcifications/cm2 was the most important parameter. Less than 10 calcifications/cm2 resulted in an 82% chance of being benign while 10 or more calcifications/cm2 had a 44% chance of being malignant. The average distance between the calcifications in the cluster was also significant, with a 92% chance of being benign if greater than 1 mm and a 52% chance of being malignant if less than 1 mm. The remaining parameters did not yield statistically significant results, but there were trends which suggest that less than 10 clustered calcifications that are regular in size and shape and orderly in appearance tend to be benign while disorderly clusters tend to be malignant. In order to decrease the number of false positive biopsies and improve the cost-effectiveness of screening mammography, radiologists should consider 6-month follow-up mammography as a reasonable alternative for clustered calcifications that appear benign.

Breast↗
PubMed1989

The lack of sonographic image degradation after barium upper gastrointestinal examination.

The presence of barium in the gastrointestinal tract after barium studies of the stomach and colon is thought to interfere with the performance of abdominal sonography. This notion results in delays in diagnosis and scheduling inconveniences when both studies are indicated at the same time. To determine if this belief is true, we prospectively obtained sonograms before and after biphasic upper gastrointestinal examinations in 40 patients. The 80 sonograms were randomized and blindly interpreted by two radiologists who used a scale from 0 to 4 to rate the appearance of six anatomic areas (gallbladder, pancreas, aorta, porta hepatis, and right and left lobes of the liver). The results showed no degradation of the image of these structures on the sonograms obtained after the barium meal compared with the prebarium sonograms. We conclude that barium does not interfere with sonography performed immediately after an upper gastrointestinal examination. Consequently, when both studies are needed, a sonogram can be scheduled after an upper gastrointestinal exam.

Abdomen↗
PubMed1988

What happens to patients after upper and lower gastrointestinal tract barium studies?

We investigated the occurrence of new constipation, diarrhea, nausea, vomiting, visible blood in stool, abdominal pain, black stools, belching, and flatus in 324 outpatients following upper or lower gastrointestinal tract barium procedures. We also evaluated the roles of age, sex, patient mobility, and types of barium enema (single- or double-contrast). At least one new symptom was reported after 51% of all examinations. Constipation was the most frequently reported single symptom after barium meal or small bowel examinations. Fifty percent of all constipation occurred following upper gastrointestinal examinations. Abdominal pain was common in patients of the seventh decade, especially following barium enema. Nausea typically followed barium swallow or upper gastrointestinal series. Belching and passage of flatus were the most frequently reported symptoms after barium enema, both single- and double-contrast. No significant relationship between the frequency of symptoms and patient age, sex, or the type of barium enema was established.

Adult↗
PubMed1988

Radiology reporting: attitudes of referring physicians.

Despite the importance of radiology reports in communicating radiologists' interpretations of imaging studies, little appears to be known about the preferences and attitudes of referring physicians regarding the format and content of such reports. The authors surveyed all physicians who referred patients to the radiology department for their opinions of radiology reports. Two hundred fifty-one physicians (42%) responded. The overall quality of the reports was rated an average of 8 on a ten-point scale, with 10 representing the highest quality. Fifty-nine percent said the reports usually were clear, but 40% thought the reports were occasionally confusing. Forty-nine percent noted the reports sometimes did not sufficiently address the clinical questions. Thirty-two percent preferred the summary statement to be at the beginning of the report, while 29% preferred this portion at the end. Forty respondents (16%) thought that it took too much time to receive the reports. This survey can serve as a model for other radiology departments interested in assessing the attitudes of referring physicians toward radiology reports.

Arizona↗
PubMed1987

AUR memorial award--1987. The impact of focused instruction on learning mammography.

Recent promotion of breast cancer screening has increased the demand for mammography services and well-trained mammographers. To determine whether focused instruction, which may occur in continuing medical education courses, is effective in imparting mammography skills and knowledge, an instructional program was developed and evaluated. Seventeen physicians were tested before and after six 1-hour instructional sessions about breast disease and cancer screening, mammogram interpretation, and determining appropriate patient disposition. Twelve weeks after instruction, subjects demonstrated significant improvement in factual knowledge, in decision-making ability regarding patient disposition, and in recognition of benign disease on mammograms. There also was significant improvement in specificity, but no improvement in cancer detection. Further, no correlation between participants' subjective self-assessment of improvement and their actual performance on the postinstruction evaluation was found. Evaluation of instructional programs is necessary to determine their effectiveness, and promotes improvement in instructional offerings.

Breast Neoplasms↗